How to file an eligibility appeal?

TennCare can help. Has your application been denied? Or do you have to pay co-pays and disagree with how much you have to pay? Or do we have your income or family size wrong?

Some people applied at healthcare.gov but have still not gotten a decision. Have you waited for a decision for more than 45 days (or more than 90 days if you applied for long-term care)? You can now ask for a “delay hearing”. To ask for a delay hearing, call us at 1-855-259-0701. OR down load TennCare Eligibility Appeal. If you click on the link, fill out the page and follow the instructions. That page tells you how to send it to us by mail or fax.

If we can find proof you applied, we’ll work your application. We may need more facts from you. If we do, we’ll send you a letter that says what facts we need to finish your application. You will have 10 days to send us the proof we ask for. After we get the facts we need, we will finish working your application and send you a letter about our decision.

What if we don’t get the facts we need within 10 days? You will get another letter that says your application is denied.

If we can’t find proof you applied, we will send you a letter and ask you to give us the proof. You will have 10 days to send us proof that you applied. After we get the proof from you, we’ll finish working your application. What if we don’t get proof that you applied within 10 days? You’ll get another letter that says your request for a delay hearing is denied.

When we have proof of your application date, we’ll give you a decision on your application. Or we will give you a hearing within 45 days (or 90 days for CHOICES applications). If we give you a hearing, we start counting on the day we find proof you applied or on the day that you send your proof to us (whichever day is earlier).